European journal of obstetrics, gynecology, and reproductive biology
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Nov 2011
Self-perceived impact of simulation-based training on the management of real-life obstetrical emergencies.
To evaluate the self-perceived impact of attending a simulation-based training course on the management of real-life obstetrical emergencies. ⋯ Healthcare professionals who participated in a simulation-based training course in obstetrical emergencies perceived a substantial improvement in their knowledge and skills when witnessing real-life emergencies. Improvements seem to be particularly relevant for obstetric nurses and for those who witness all trained obstetrical emergencies.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Nov 2011
Review Practice Guideline Comparative StudyInstrumental delivery: clinical practice guidelines from the French College of Gynaecologists and Obstetricians.
Routine use of a partograph is associated with a reduction in the use of forceps, but is not associated with a reduction in the use of vacuum extraction (Level A). Early artificial rupture of the membranes, associated with oxytocin perfusion, does not reduce the number of operative vaginal deliveries (Level A), but does increase the rate of fetal heart rate abnormalities (Level B). Early correction of lack of progress in dilatation by oxytocin perfusion can reduce the number of operative vaginal deliveries (Level B). ⋯ Training must ensure that obstetricians can identify indications and contra-indications, choose the appropriate instrument, use the instruments correctly, and know the principles of quality control applied to operative vaginal delivery. Nowadays, traditional training can be accompanied by simulations. Training should be individualized and extended for some students.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Nov 2011
ReviewThe introduction of intra-operative cell salvage in obstetric clinical practice: a review of the available evidence.
Intra-operative blood salvage is common practice in many surgical specialties but its safety is questioned with concerns about the risks of contamination of recovered blood with amniotic fluid and of maternal-foetal alloimmunization. However, the role of cell salvage as a blood-saving measure in this clinical setting is progressively acquiring relevance thanks to the growing body of evidence regarding its quality and safety. ⋯ Maternal alloimmunization can be caused also by other foetal red cell antigens, but it should also be noted that the risk of alloimmunization of the mother from allogeneic transfusion may be even greater. Therefore the use of cell savers in obstetric clinical practice should be considered in patients at high risk for haemorrhage or in cases where allogeneic blood transfusion is difficult or impossible.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Nov 2011
Review Case ReportsSurgical management of valvular heart diseases in pregnancy.
Heart disease in pregnancy remains one of the important causes for maternal and fetal mortality and morbidity. Cardiac surgery undertaken in pregnancy presents specific additional issues for both the mother and fetus; especially cardiopulmonary bypass and the factors associated with it. ⋯ We present our experience of two cases where cardiopulmonary bypass surgery for cardiac valve replacement was successfully performed during pregnancy without any maternal or fetal mortality. A review of published literature is also undertaken in order to present evidence based recommendations for undertaking such procedures in pregnancy.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Nov 2011
Cardiotocography as a predictor of fetal outcome in women presenting with reduced fetal movement.
To examine the obstetric and perinatal outcomes of women presenting with reduced fetal movement (RFM) during the third trimester, specifically in relation to the diagnostic capacity of non-stress cardiotocography (CTG) used as the primary investigation in this clinical scenario. ⋯ Normal non-stress CTG is a reliable screening indicator of fetal wellbeing in women presenting with perception of RFM in the third trimester; abnormal pregnancy outcomes were more common when initial CTG was abnormal or persistently non-reassuring.